BACKGROUND Glaucoma is the second most leading cause of visual loss in the world. Different socio epidemiological parameters like gender, age, socio-economic status, educational status etc. has been directly linked to occurrence of glaucoma in previous studies. Review of the western literature showed that the risk factors associated with glaucoma were high intra ocular pressure (IOP), low blood pressure, low ocular perfusion pressure, narrow anterior chamber angles, thin corneas, pseudoexfoliation, a low body mass index (BMI), and myopia. We need to evaluate the clinical and epidemiological factors affecting primary open angle glaucoma. METHODS Records of patients with a diagnosis of primary open-angle glaucoma (POAG) were studied. All data, addressing demographics (gender, age and skin colour), socioeconomic status, educational status, emotional status and clinical information concerning risk factors for developing glaucoma (family history of glaucoma, hypertension and diabetes mellitus) and any treatment history (e.g., corticosteroid intake) were noted. Findings from visual acuity examination, refraction, detailed anterior segment examination by slit lamp, fundus examination with 90 D, gonioscopy, applanation tonometry, VF examination by automated perimetry and A-scan USG were also carefully taken into account. RESULTS A total 920 patients were enrolled of which 67.94 % were males and 57.6 % were from urban population. 18.7 % cases had positive family history. Most of the patients came from lower and middle-income group (43.48 % and 48.37 % respectively). Cup-disc ratio of majority of eyes was found to be more than 0.30 (97.29 %). Different grades of disc changes and field changes were noted. Cupdisc ratio asymmetry of more than 0.20 was found in 355 (38.59 %) eyes. Paracentral and / or arcuate scotoma was detected in 585 eyes (31.80 %). CONCLUSIONS Understanding the socio-demography and socio-economy helps in early diagnosis and better assessment of the disease severity in POAG. KEYWORDS Glaucoma, POAG, CDR, Visual Fields
Introduction: Diabetic Retinopathy (DR) is a major complication of Diabetes Mellitus (DM), which remains a leading cause of visual loss in working age populations. The most common cause of vision loss in patients with DR is Diabetic Macular Oedema (DME). Intravitreal administration of anti-Anti-Vascular Endothelial Growth Factor (anti-VEGF) agents is currently the mainstay of therapy for both early and advanced stages of DR. Aim: To compare long-term change in Central Macular Thickness (CMT) and Best Corrected Visual Acuity (BCVA) in patients with Non Proliferative Diabetic Retinopathy (NPDR) with Clinically Significant Macular Oedema (CSME) after receiving Intravitreal Ranibizumab (IVR) following monthly, Pro Re Nata (PRN) protocol and TreaT&Extend (T&E) protocol. Materials and Methods: This is a hospital based longitudinal prospective cohort study conducted on patients attending the Out Patient Department (OPD) of the Opthalmology Department at Midnapore Medical College & Hospital West Bengal, India. from October 2018 to February 2021. Institutional Ethical clearance was obtained prior to the initiation of the study. Among 93 patients, 31 were chosen each for IVR PRN Monthly (Group A), (Group B) and T&E protocol (Group C) over a period of nine months. CMT and BCVA were measured at baseline and followed up monthly for 12 months after last injection using Spectral Domain Optical Coherence Tomography (SD-OCT), while Glycated Haemoglobin (HbA1c) level was maintained below 7.4. Statistical analyses were performed using Statistical Package of Social Sciences (SPSS) statistics version 20 software. Chi-square test was used to find out the association between categorical variables. Pre and post comparisions were done using Wilcoxon sign rank test. A p-value less than 0.05 were considered as statistically significant. Results: There was significant decrease in CMT and betterment of BCVA in all groups at the end of treatment compared to baseline. At six months and one year of last injection there was no significant change in CMT in group A and C while group B at one year (p=0.0487) showed significant increase. There was no significant worsening of BCVA in group A and group C while group B (p=0.01) showed significant worsening at one year longterm follow-up. Conclusion: Thus, the present study concludes that, even though monthly protocol T&E protocol are equally good compared to PRN protocol on the basis of long-term beneficial effect, T&E protocol needed comparatively fewer doses of IVR compared to monthly protocol making it the choice of protocol for long-term control in NPDR with DME patients.
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